PROJECT SPECIFIC VENDOR QUESTIONNAIRE EMPLOYEE BENEFITS CONSULTING SERVICES

Transcription

1 PROJECT SPECIFIC VENDOR QUESTIONNAIRE EMPLOYEE BENEFITS CONSULTING SERVICES Proposer is being asked to provide the following services. Proposers are asked to specify their ability to provide these services. If Proposer cannot provide any of the following services, the Proposer must so indicate with a NO and brief explanation. 1. MINIMUM REQUIREMENTS Broward County will award a contract under this RFP directly to the carriers or companies that provide the requested services and will require a signature from an authorized representative with the authority to commit the carrier or company to all requirements of the RFP. Awardee may contract with independent agents or brokers separately from its contract with Broward County. Nothing in this RFP will be construed to restrict compensation, contractual or employment arrangements that an Awardee may grant to a licensed insurance agent or to otherwise violate Section or Section , Florida Statutes Proposer agrees to a premium rate guarantee for the first three years of the contract. ELIGIBILITY FILES/ELECTRONIC DATA EXCHANGES Proposer agrees that all data exchanges (file transmission, , media, etc.) between Vendor and County should be encrypted and only de-encrypted by the specified recipient. In addition, Vendor is required to use a secure venue to exchange files to and from third party vendors outside of the organization. All electronic files will be in the most current HIPAA compliant format. ACCOUNT MANAGEMENT, PAYMENT, REPORTING AND AUDITING on page 76 of 119 of the vendor response submittal) The services being requested are for flat monthly amounts, annual amounts and/or hourly rates, these are not premiums. Gallagher can provide the flat monthly amounts, annual amounts and/or hourly rates beyond the 3 years. We are willing to extend our fixed fees for the full 5 years. Gallagher has secure site to exchange data needed for our data warehouse system. on page 44 of 302 of the vendor response submittal) 4. Proposer agrees to provide an account manager for the group contract who will visit the County s Employee Benefits Section no less than quarterly. on page 333 of 385 of the vendor response submittal) on page 45 of 302 of the vendor response submittal) 5. Proposer agrees to establish an account management and servicing relationship with the County that emphasizes proactive, regular contact, timely responses to administrative issues and requests. At a minimum on an annual basis the Gallagher Team will develop a Client Service Plan to outline each year projects and a working calendar to ensure all expectation are met. on page 45 of 302 of the vendor response submittal) 6. Proposer agrees to periodically provide reasonable access to County-appointed auditor(s) to perform audits to determine accuracy of payments and appropriate administration for vendor and subcontractors. Vendor agrees to make the County We agree. HDI s data center is fully auditable for HIPAAcompliance by federal, state, and local agencies. However this would be limited to the Consulting Agreement records that are related specifically to the Wells Fargo Insurance has the appropriate E& O coverage as outlined in the Evidence of Insurance document provided in Appendix II. We will provide access via Page 1 of 7

2 whole financially for errors identified and, in the event errors are discovered that exceed industry standards, pay for the cost of such audit. Agreement. No is no typically audit since the deliverables are different than those of a carrier. electronic DTS folders for any audits that will include full and complete copies of all records for this account. EMPLOYEE BENEFITS CONSULTING SERVICES 7. Describe briefly your firm's organizational structure and provide a copy of your organization chart showing lines of reporting and responsibility. on page 90 of 119 of the vendor response submittal) on page 302 of 385 of the vendor response submittal) on page 49 of 302 of the vendor response submittal) 8. List the name of the lead consultant who will provide ongoing consultation services to Broward County (the County) under this contract. For this individual provide the following: Description of consultant experience, education, length of employment at your firm, length of employment as a consultant, professional credentials and affiliations, principal area of strength. Mark Lynne President, Health Plan Consulting Division on page 63 of 119 of the vendor response submittal) Barbara Crowe Area Vice President on page 334 of 385 of the vendor response submittal) Susan O Hara White Senior Consultant on page 52 of 302 of the vendor response submittal) Provider 9. Identify the consultant who will provide back-up to the individual listed above and submit the same background information. James Downing Senior Consultant Michelle Nathan Back-Up Lead & Senior Account Executive Katherine Pritchett Senior Account Executive on page 64 of 119 of the vendor response submittal) on page 336 of 385 of the vendor response submittal) on page 53 of 302 of the vendor response submittal) 10. How many of your clients do you currently work with on a broker basis? How many on a consultant basis? Four large (300+ employees) public sector employers for whom we provider ongoing retainer services: Broker basis 2 Consultant basis - 20 For the consultants assigned to the County all clients are on a consulting basis. As for the South Florida operations - 50% of our business is derived on a broker basis, and the other 50% is on a consultant basis. All of the clients with whom Susan and the Account Management team works with are on a consulting basis. Katherine and Susan share 5 large clients and Broward Government is one of the 4. Susan shares 4 other consulting clients with another Account Manager and Katherine shares 2 clients with another Senior Consultant. 11. Does proposer provide in-house actuarial services? on page 337 of 385 of the vendor response submittal) on page 55 of 302 of the vendor response submittal) 12. If yes to the question above, list the name of the principal actuary who will provide ongoing actuarial services to the County under this contract. For this individual provide the following: Description of actuarial experience, education, length of employment at your firm or length of contract to provide services to your firm, length of employment as an actuary, professional credentials and affiliations. (If sub-contracted please note this here and also complete Section: Sub-Contractors) Kevin Binder Senior Actuary on page 77 of 119 of the vendor response submittal) Glen Volk Area Vice President, Consulting Actuary on page 339 of 385 of the vendor response submittal) Nick Allen Senior Account Executive on page 56 of 302 of the vendor response submittal) Page 2 of 7

3 13. Has proposer performed an actuarial attestation of a self-insured pharmacy plan for Medicare D subsidies? If yes, indicate number of annual filings. Bolton Partners has provided this service to clients since the program s inception; we are currently providing this service to 37 clients., we prepare dozens of actuarial attestations each year. We prepare 15 to 20 in Florida and over 75 nationally. Wells Fargo Insurance performs approximately (20) actuarial attestations annually Has proposer prepared and submitted FLOIR filings for self-insured plans? If yes, indicate number of annual filings. Does proposer have specialized consultants/services in the following areas: Clinical Pharmacy Benefit Management Disease Management Wellness Initiatives Data Warehousing Actuarial Services Legal and Compliance Provider Contracting and Network Development Bolton Partner has prepared FLOIR filings for self-insured plans in the past and is familiar with the process. on page 78 of 119 of the vendor response submittal), Gallagher performs many FLOIR state filings for selfinsured plans each year. Each year we prepare approximately 25 FLOIR filings for self-insured plans. The number increases each year as more public sector clients move towards a self-insured arrangement. on page 340 of 385 of the vendor response submittal) Wells Fargo Insurance works with the County s third party service provider who processes the County s annual FLOIR filing. The service provider processes approximately (20) filings annually. on page 57 of 302 of the vendor response submittal) 16. List resources and tools used for benchmarking. on page 79 of 119 of the vendor response submittal) on page 343 of 385 of the vendor response submittal) on page 74 of 302 of the vendor response submittal) 17. List resources and tools you offer clients to help achieve wellness and disease management program goals? on page 79 of 119 of the vendor response submittal) on page 344 of 385 of the vendor response submittal) on page 74 of 302 of the vendor response submittal) 18. Does proposer have experience in monitoring, evaluating, and determining ROI for wellness and disease management programs? on page 79 of 119 of the vendor response submittal) on page 345 of 385 of the vendor response submittal) on page 76 of 302 of the vendor response submittal) 19. Does proposer have experience working with third party claims or a data analysis vendor? If yes, in what capacity? / on page 80 of 119 of the vendor response submittal) / on page 347 of 385 of the vendor response submittal) / Wells Fargo Insurance has worked side by side with many different data analytics vendors and is successfully working with Benefit Science today. 20. If yes to the question above, list the various ways you have worked with such a vendor for the benefit of your client i.e. analyzing benefits, claims trends, risk sharing arrangements, etc. on page 81 of 119 of the vendor response submittal) on page 347 of 385 of the vendor response submittal) Wells Fargo Insurance has worked with data analytics at many different levels, including: benefit analysis and Page 3 of 7

4 benefit change recommendations, historic claims trend, enrollment analysis, cost share, etc. 21. Does proposer have experience in the evaluation of historical trend factors and development of trend assumptions for future claims projections? / on page 81 of 119 of the vendor response submittal) / on page 348 of 385 of the vendor response submittal) / on page 80 of 302 of the vendor response submittal) 22. Does proposer publish newsletters and other informative publications or alerts that are routinely provided to your clients? on page 348 of 385 of the vendor response submittal) on page 82 of 302 of the vendor response submittal) 23. Does proposer monitor regulatory and legislative developments at both the state and federal level? If yes, how these are communicated to clients. on page 90 of 119 of the vendor response submittal) on page 349 of 385 of the vendor response submittal) 24. Describe briefly your ability to provide legal research in such areas as compliance with Health Care Reform, IRS Code Section 125, HRA, HSA, COBRA and other benefit related rules, guidelines or laws. on page 82 of 119 of the vendor response submittal) on page 350 of 385 of the vendor response submittal) 25. Do you have clients with self-insured health and pharmacy plans? State the number of clients you have with a self-insured health and pharmacy plans? All of Bolton Partners large public sector clients (of at least 1,000 employees) are self-insured for health and pharmacy. There are 20 clients in this category. In Florida, Gallagher assists over 100 clients with their selfinsured pharmacy plan. Unique to Gallagher, we have developed a PBM Team consisting of Pharmacy specialist including Pharm D s this has been a growing area of expense and to ensure our clients are on the cutting edge, we review PBM contracts not just for AWP and other discounts, but truly look at how each item is being defined within the PBM contract. This review process has had a major cost impact on our clients programs. The entire book of business managed by the Wells Fargo Insurance Account team is self-funded. They vary in size, but all clients are self-insured. 26. Do you have clients you have assisted with a solicitation, analysis and negotiation of a self-insured health and pharmacy plan? Specify how many. We conduct solicitations every year for our public-sector clients. These average three per year. In the past two years, we have performed Request for Proposal processes for medical, dental, prescription, life, disability, and voluntary benefits, as well as for FSA administration stoploss reinsurance, and benefits administration platforms. These were for clients ranging in size from 1,000 to 6,000 In Florida and over time, Gallagher assists over 100 clients with the solicitation, analysis and negotiation of their selfinsured pharmacy plans. Since a solicitation may not occur each year, the amount of solicitations performed will vary year-to-year. The Wells Fargo Account team has assisted all of their clients in the procurement, solicitation, analysis, evaluation and negotiation process. Page 4 of 7

5 employees/ retirees, and were primarily for clients in the public sector. 27. Does proposer have experience in health insurance utilization review, quality assessment and clinical evaluation of a health plan's performance? on page 351 of 385 of the vendor response submittal) 28. Does proposer have experience with determining the amount of stop loss coverage needed? If yes, describe briefly how you evaluate a carrier's stop loss proposal. / on page 84 of 119 of the vendor response submittal) / on page 352 of 385 of the vendor response submittal) / on page 85 of 302 of the vendor response submittal) 29. Does proposer have experience about tax related issues? If yes, is this experience in-house or sub-contracted? If sub-contracted, state who you use for these services and the level of expertise or credentials of this sub-contractor. No on page 84 of 119 of the vendor response submittal) on page 353 of 385 of the vendor response submittal) on page 86 of 302 of the vendor response submittal) DATA WAREHOUSE AND REPORTING 30. What is the name of your data warehouse vendor? Health Data Intelligence, LLC. We are also able to work with BST should you desire to maintain them, and we are very familiar with their system. GBSInsider Gallagher has in-house developed, owned and propriety data warehousing. Benefits Science Technology 31. Can you provide reporting access to County Benefits staff? Both the dashboard application and the database are rolebased. County staff fully controls the level of user access to each module. Gallagher has the capabilities to provide the County with access, however, this would require a custom data feeds from your Medical and Pharmacy vendors. We are willing to discuss the cost of custom data feeds. Bulk data feeds have been included in the cost. 32. Briefly describe your firm s implementation strategy while transitioning or establishing a data warehouse on page 85 of 119 of the vendor response submittal) We are willing to work with the County to transition any data. However, since Gallagher has its own data warehouse we can receive data directly from the carriers/vendors. SUB-CONTRACTORS Page 5 of 7

6 34. Is proposer using any sub-contractors? No No 35. If yes to the question above, please list the name of any subcontractor to be used to provide services to the County and detail their experience and credentials. List why you have selected this sub-contractor. on page 86 of 119 of the vendor response submittal) 36. Detail the scopes of services the sub-contractors will perform? How do you monitor quality and correctness? on page 86 of 119 of the vendor response submittal) 37. Provide the reasons you are sub-contracting the services detailed above. on page 87 of 119 of the vendor response submittal) 38. List the benefit(s) of sub-contracting the services identified? In general, we seek specialist expertise that would entail prohibitive costs to build; and this provides proper value that allows an appropriate amount of resources dedicated to a given project(s). We are not using any subcontractors. However, we believe that subcontracting services to other vendors, there is the potential of a loss in the translation of data, data is being shared potentially with more vendors than necessary and the overall loss of control of such vendors. Potentially leading to a delay in project turnaround and more costly services. 39. Do you evaluate and check references of subcontractors before selection? If yes, please provide a brief description of your evaluation process including frequency of evaluations and ratings used, etc. / on page 87 of 119 of the vendor response submittal) 40. Do you enter into a formal contract with each sub-contractor? 41. Do you have Performance Guarantees with your Sub-contractors? List in detail any Performance Guarantees you have with your Subcontractors (identified and broken out by Subcontractor). / on page 88 of 119 of the vendor response submittal) Page 6 of 7

7 FOR INFORMATIONAL PURPOSES ONLY NOT TO BE INCLUDED AS PART OF SCORING VENDOR FEES/COMPENSATION Bolton Partners Inc. Gallagher Benefits Services, Inc If County wanted to explore a Broker of Record form of compensation, explain in detail how your proposal would work as regards receiving a percentage of premium for: Solicitation projects, renewal projects, general research and advice, etc. If you were to become a Broker of Record and receive a percentage of premium; a. Does your firm agree to provide transparency and report your compensation to the County? b. What would be the frequency of reporting this information? c. Would your firm accept carrier overrides? d. Would your firm take compensation beyond the commission built into premium rates? e. Would there be a maximum annual fee you would receive? We would build commission into premiums which would equal our quoted fixed fees. It the amount of work exceeded the commissions built into the premiums, we discuss that with County staff and with upon agreeing and approving an amount commensurate with the expected work level, we would adjust the commission level for the next plan year. Commissions can be adjusted annually. on page 89 of 119 of the vendor response submittal), Gallagher would be willing to explore alternate compensation arrangements for Broward County. With a client of Broward County's size commission-based compensation would probably be additive to the existing premiums. In the small group market "standard commissions" are already built into each product line. For experience rated clients commissions must be included in the underwriting process. A commission structure could allow the County to receive the services requested and spread the consultant's compensation between both Broward County paid products and employee paid products. Gallagher would be willing to work on a flat percentage or flat fee structure. on page 356 of 385 of the vendor response submittal) - Wells Fargo can accept industry standard compensation by line of coverage or negotiate a mutually agreed upon compensation level. on page 89 of 302 of the vendor response submittal) How would you maintain no conflict of interest? 44. Describe the pros and the cons to the County of receiving your compensation as fees vs. Broker of Record commission? on page 89 of 119 of the vendor response submittal) on page 356 of 385 of the vendor response submittal) on page 91 of 302 of the vendor response submittal) RESPONSE VERIFICATION 45. HAVE YOU ANSWERED EVERY QUESTION IN THE VENDOR QUESTIONNAIRE? Balance of Page Left Blank Intentionally Page 7 of 7